Studies have shown that youth smoking increases during times when the tobacco industry steps up promotional activity. Since the 1998 Master Settlement Agreement (MSA) restricting certain types of tobacco marketing to youth, the tobacco industry is relying more heavily on retail stores as marketing outlets, spending $14.2 billion on retail advertising in 2003. This study surveyed 26,301 8th, 10th, and 12th graders to divide them into one of six categories: never smoked, puffer, non-recent experimenter, former established smoker, recent experimenter, and current established smoker. Data was then collected about retail stores surrounding the participating schools and the tobacco advertising within and surrounding the stores, in order to assess the magnitude of the association between marketing and youth smoking uptake.
This study, the first to examine the differential impact of objectively collected measures of cigarette marketing strategies on smoking uptake, shows that different marketing strategies have differential effects on progression from initiation and experimentation to regular smoking. Point-of-sale advertising is associated with encouraging youth to try smoking, whereas promotions influence youth already experimenting to progress to regular smokers. Current established smokers were most influenced by promotions. Eighth graders were more influenced than older youth by all advertising methods. Price-based promotions are particularly appealing to young, price-sensitive smokers and may cancel out some of the effects of higher cigarette prices.
These results suggest that, although the MSA restricted some of the industry's promotional and advertising activities, the increase in retail advertising is offsetting some of the MSA's benefits in reducing marketing. The authors suggest that restricting point-of-sale advertising and price-based promotions will help prevent youth from moving along the uptake continuum toward regular smoking.